The COVID-19 pandemic and disruptions in a district quality improvement initiative : experiences from the CLEVER Maternity Care programme
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Date
Authors
Oosthuizen, Sarie J.
Bergh, Anne-Marie
Silver, Antonella
Malatji, Refilwe
Mfolo, Vivian
Botha, Tanita
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS
Abstract
BACKGROUND : Many health systems were poorly prepared for the coronavirus disease 2019
(COVID-19) pandemic and found it difficult to protect maternity and reproductive health
services. The aim of the study was to explore the influence of the COVID-19 pandemic on the
ability of maternity healthcare providers to maintain the positive practices introduced by the
CLEVER Maternity Care programme and to elicit information on their support needs.
METHODS : This multimethod study was conducted in midwife-led obstetric units (MOUs) and
district hospitals in Tshwane District, South Africa and included a survey questionnaire and
qualitative reports and reflections by the CLEVER implementation team. Two five-point
Likert-scale items were supplemented by open-ended questions to provide suggestions on
improving health systems and supporting healthcare workers.
RESULTS : Most of the 114 respondents were advanced midwives or registered nurses (86%).
Participants from MOUs rated the maintenance of quality care practices significantly higher
than those from district hospitals (p = 0.0130). There was a significant difference in perceptions
of support from the district management between designations (p = 0.0037), with managers
having the most positive perception compared with advanced midwives (p = 0.0018) and
registered nurses (p = 0.0115). The interpretation framework had three main themes: working
environment and health-system readiness; quality of patient care and service provision; and
healthcare workers’ response to the pandemic. Health-facility readiness is described as
proactive, reactive or lagging.
CONCLUSION : Lessons learned from this pandemic should be used to build responsive health
systems that will enable primary healthcare workers to maintain quality patient care, services
and communication.
Description
Keywords
Health-systems readiness, Maternity services, Quality, CLEVER maternity care, Working environment, Communication, COVID-19 pandemic, Coronavirus disease 2019 (COVID-19), Midwife-led obstetric units (MOUs)
Sustainable Development Goals
Citation
Oosthuizen, S.J., Bergh, A.-M., Silver, A., Malatji, R.E., Mfolo, V. & Botha, T. The COVID-19 pandemic and disruptions in a
district quality improvement initiative: Experiences from the CLEVER Maternity Care programme. South African Family Practice 2022;64(1), a5359.
https://DOI.org/10.4102/safp.v64i1.5359.